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Donald Nixon Ross, DSc, FRCS, thoracic surgeon, was a pioneer of cardiac surgery who led the team that carried out the first heart transplantation in the United Kingdom in 1968, having, more significantly, developed the pulmonary autograft, known as the Ross procedure, for treatment of aortic valve disease.

Ross was born of Scottish parents in Kimberley in South Africa. He began his medical career enrolling as a student at the University of Cape Town, training first as a dedicated scientist and subsequently as a doctor. He graduated (BSc, MB, ChB) in 1946 with first-class honours and the university gold medal. He had also received a two-year overseas scholarship which allowed him to further his studies in the United Kingdom.

Once in England he took up a career in surgery and became a Fellow of the Royal College of Surgeons (1949) within two years instead of the usual three. Working initially in Bristol he focused on chest and oesophageal surgery, and then began to include early cardiac surgery.

Ross had been a fellow student of Christiaan Barnard at the University of Cape Town, the man who carried out the world’s first heart transplantation. It was in 1968 that Donald Ross led the team of doctors and nurses at the National Heart Hospital in London in the United Kingdom’s first heart transplantation. The operation, on a 45-year-old man, lasted 7 hours. The patient survived for another 46 days before dying from what was described at the time as an “overwhelming infection”.

There had been a surge of media attention around the heart transplantation, but the team had not considered the surgery itself particularly unique or challenging. The greatest issue faced was overcoming rejection of the newly transplanted heart. “We did not feel we had achieved any particular advances in transplantation at that time,” Ross said, “and we stopped after the third transplantation because the problem of rejection had not been overcome.”

Ross’s greater achievement was the development, in 1967, of what has been termed the Ross procedure, or pulmonary autograft for aortic valve disease.

In 1962 Ross introduced the use of homografts to replace diseased aortic valves. The pulmonary autograft, now widely known as the Ross procedure, first performed in 1967, was the logical development of the homograft: it involves replacing a patient’s damaged aortic valve with his or her own pulmonary valve.

Donald Ross also pioneered cardiac surgery here at The Harley Street Clinic. Cardiac surgery was rarely performed privately in this country and Donald Ross helped instigate technological, staffing and care requirements here enabling us to become the leading private hospital for both adult and paediatric patients.

The Hospital send its condolences to Donald’s family, friends and colleagues.

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